Health

Effectiveness of vaginal Papanicolaou smear screening after total hysterectomy for benign disease

Article Abstract:

There is little evidence to support giving routine Pap smears to detect vaginal cancer to women who have had a hysterectomy if the woman has no history of abnormal smears. Eighty-five percent of hysterectomies in the US are done to treat benign disease. An estimated 5.72 million Pap smears are done annually in these women, at a cost of $43.5 million to $350 million. Several studies have reported an increased risk of vaginal cancer in these women, while other studies have found no risk. Cancer originating in the vagina is very uncommon, with an incidence of 0.2 to 0.7 cases per 100,000 women. It is also not clear that early detection reduces mortality rates. The sensitivity of Pap smears in detecting early-stage vaginal cancer may be low. Consequently, the test may not pass the criteria for an effective screening test. These include proof that the test is accurate in detecting the condition and that people diagnosed early have better outcomes.

Author: Reed, Barbara D., Fetters, Michael D., Fischer, Gayle

Publisher:American Medical AssociationPublication Name:JAMA, The Journal of the American Medical AssociationSubject:HealthISSN:0098-7484Year:1996

Health aspects, Usage, Pap test, Hysterectomy, Vaginal cancer

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The Cost-effectiveness of Screening for Type 2 Diabetes

Article Abstract:

Mass screening of young adults for type 2 diabetes can reduce the incidence of diabetic complications and lower the age at diagnosis. Undiagnosed diabetes, in which the blood glucose level remains high, can cause vascular disease, kidney disease, blindness, and other conditions. Researchers produced a computer model to estimate the costs associated with a population screening program. Screening adults 25 years of age and older reduces the age at diabetes diagnosis by about six years, and reduces the lifetime incidence of diabetes complications by 22-35%. Screening young adults and African Americans appears to be more cost-effective than screening older adults.

Publisher:American Medical AssociationPublication Name:JAMA, The Journal of the American Medical AssociationSubject:HealthISSN:0098-7484Year:1998

Type 2 diabetes, Blood sugar monitoring, Blood glucose test

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Screening for proteinuria in US adults: a cost-effectiveness analysis

Article Abstract:

Screening all Americans for protein in the urine beginning at the age of 50 and every year after is not cost-effective, according to researchers who used a Markov decision analytic model to compare various screening strategies. It would be more cost-effective to screen only those 60 years old or older and those with high blood pressure. Protein in the urine is a sign of kidney disease, which is more easily treated if detected early.